Fertility Treatments at Cape Fertility during Covid-19

During the initial lockdown locally, based on senior legal opinion, fertility clinics were entitled to continue with essential services for patients of advanced age; patients with a diminished ovarian reserve; patients with poor prognosis for whom time is essential and for oncofertility patients.

This meant fertility clinics could continue to care for patients who are currently in a treatment cycle, while considering freezing of all eggs or embryos for patients who are in a treatment cycle. It also meant fertility clinics could continue care and initiate cycles for patients who require urgent stimulation and cryopreservation for oncology or other urgent indications.

While fertility clinics could continue to care for patients who required emergency surgery, such as ectopic pregnancy, retained products of conception, acute abdomen, acute very severe pain and certain oncological procedures, all elective and semi-elective surgery was suspended.

It also meant no initiation of new treatment cycles, including ovulation induction, intrauterine inseminations, in vitro fertilisation including egg retrievals and frozen embryo transfers, as well as elective gamete cryopreservation. Fertility clinics were also strongly advised to consider cancellation of all embryo transfers, fresh or frozen.

Since the beginning of May, when South Africa went into Lockdown Level 4, all fertility treatments are now allowed under strict safety regulations, but it is not quite business as usual.

To ensure that fertility clinics adhere to global best practice, the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG) continues to issue updated Covid-19 guidelines.

The society represents specialists – ranging from gynaecologists, embryologists and scientists to fertility and theatre nursing sisters, allied practitioners, psychologists and social workers in the field of Gynaecological Endoscopy and reproductive medicine – and serves to protect the interests of patients undergoing fertility treatment.

Cape Fertility is very proud to be a SASREG-accredited fertility clinic. In addition, one of our fertility specialists, Dr Sulaiman Heylen is currently the President of SASREG. Along with Dr Nomathamsaqa Matebese, also a fertility specialist at Cape Fertility, Dr Heylen was part of the team that created the COVID-19 best practice guidelines for fertility clinics in South Africa.

These best practice guidelines mean that a few things have changed in the way that fertility treatments are provided to ensure individuals and couples looking to start or continue fertility treatment will be able to continue to do so safely.

Who can receive treatment?

Patients diagnosed with COVID-19 and those who had contact with persons diagnosed with COVID-19, should not undergo any fertility surgery or procedure.

Patients who are currently in the treatment cycle and are asymptomatic and have not had contact with someone diagnosed with COVID-19 should continue with the treatment as planned if they so wish. They should be made aware that there is little information on the future impact of fertility treatment on COVID-19 propagation.

Patients who are currently on the treatment cycle and then develop symptoms or come into contact with someone diagnosed with COVID-19, should not visit a fertility clinic. They must inform the clinic and the local medical authority dealing with COVD-19 immediately.

SASREG also suggests that elective and non-urgent surgical procedures be postponed if possible. This reduces the number of people visiting health care facilities thus reducing contact, risk of transmission and protecting healthcare professionals. It also aims to preserve critical healthcare resources. Any surgery on a COVID-19 positive patient should be delayed until their infection has fully resolved if possible.

How has fertility treatments changed?

The emphasis of the COVID-19 guidelines is on ensuring staff and patients remain safe. This means limiting the number of visits to the fertility clinic and making sure that when patients do visit a fertility clinic, they will be as safe as possible.

To minimise the number of visits to the fertility clinic, fertility specialists now offer telephonic and Skype consultations to patients whenever possible. This will ensure all nonessential travel is avoided during the fertility treatment cycle and beyond.

However, at some point patients will have to visit our clinic, and when you do, you can rest assured we have adhered to all safety and health guidelines. The guidelines include all standard precautions and preventative measures as required by the National Department of Health, while the cleaning and disinfection of common spaces are intensified.

Nevertheless, your informed consent will now be required and must be signed, preferably remotely or electronically using telephone/Skype.

Arrival times for appointments will be staggered to avoid contact between patients, ensure there is no more than 1 patient at a time in the waiting room or to allow at least 2-metre space between patients. Patients are also requested to come alone to routine monitoring visits, limiting accompanying persons and partners, and no children should be allowed to accompany the patients. A mask is required.

Social distancing is maximised during all consultations and procedures. The number of consultations per cycle will be limited and consultation time will be limited wherever possible. Procedures will be performed in an office setting rather than a theatre if possible. Patients will also be encouraged to leave the fertility clinic as soon as possible.

Alcohol-based decontamination should be provided to all patients as they enter the clinic and when they leave the clinic. All staff members and patients must have their skin temperature measured using an infrared thermometer or a similar device every time they visit the clinic. In addition, all patients should be tested for COVID-19 before a procedure.

SASREG also suggests that elective and non-urgent surgical procedures be postponed if possible. This reduces the number of people visiting health care facilities thus reducing contact, risk of transmission and protecting healthcare professionals. It also aims to preserve critical healthcare resources. Any surgery on a COVID-19 positive patient should be delayed until their infection has fully resolved If possible.

All patients must also be provided with a letter on the clinic’s letterhead that patients can provide when stopped by enforcement officers.

All patients must be carefully counselled about the risks and benefits of proceeding with fertility treatment. This counselling must include the potential pregnancy-related risks, the transmission of SARS-CoV-2 virus, cancellation of treatment and all other concerns. All patients will have to sign a specific consent form that explains the risks and benefits of fertility treatment during the COVID-19 pandemic.

What has not changed

Although the pandemic has changed our lives – and certainly the way fertility treatments are delivered – it cannot take away our hopes and dreams for the future. What has not changed is your ability to access the advice and expertise of a fertility specialist, who can recommend the best fertility treatment for your unique fertility challenges.

If you have already begun your fertility journey, you can now continue, knowing that you can do so safely at a SASREG-accredited clinic such as Cape Fertility. If you have not yet started your fertility journey, you can begin the process safely despite COVID-19.

The first step is always a consultation with a fertility specialist. Your initial consultation with one of our Cape Fertility specialists can be arranged via telephone, Skype or WhatsApp, so you can attend from the safety of your home.

Simply click here to contact us…  – we look forward to helping you commence or continue your fertility journey in the safest way possible!